Doctors need to talk to their patients, part 1

Injuries are the most common type of case Transient Workers Count Too encounters. For workers as with anyone, getting injured is far from a pleasant experience, to put it euphemistically. But as the many stories published have documented, the accident itself is often only the start of a worker’s problems and difficulties that continue through the subsequent phases of recovery and settlement.

One complication — a trend that TWC2 has noticed – arises from something that looks quite innocuous. It is that employers and their agents, when admitting an injured worker to the clinic or hospital, interact with medical staff ‘on behalf’ of the worker, many times using a language not understood by worker himself.

TWC2 was a little horrified to hear of a few cases where, months after an injury, a worker discovers that what had been recorded by the doctor as to how the accident happened, was completely different from the facts. The workers tell us that the clinical records indicate that the injuries did not take place at worksites. This seriously compromises the workers’ compensation claims.

Under the Work Injury Compensation Act (WICA), so long as an accident occurred at a workplace (and no fault needs to be proved) the employer’s insurance for medical costs and compensation can be used. But if it didn’t occur at a workplace, the worker loses this benefit, which can amount to thousands of dollars.

How often does it happen that workers themselves never get to tell their first doctor the events surrounding the accident? What impact does this have, and what do workers feel about it? To investigate this, TWC2 volunteers were doing a survey with workers at the Cuff Road Project when I visited. I sat with three workers to better understand their perceptions and the potential effect of employers talking over the workers’ heads.

In Part 1 are stories by Mokter and Arjun.

In Part 2 is Abdul Rashid’s story and TWC2’s concerns as pointed out to me by Debbie Fordyce, the coordinator of TWC2’s Cuff Road Project.

Company driver provided the account of the accident instead of the worker — in Chinese

Mokter tells me that the injury occured when he was working on a swimming pool construction project in a private home. “You know swimming pool have the marble below? Put the water put 20mm then using cutting machine.” Mokter explains as his body mimics how he used to cut the marble tilings.

“Fourth day working, I cutting, cutting, then suddenly ah, I hear the sound change. I stop, I look at the cutting machine, I see the round blade break, then everywhere blood.”

“I see already I calling, auntie auntie… then ah, the auntie — a Malaysian Chinese lady also employed in the project — she see. She like that . . .” Mokter starts to shake his whole body, imitating the trembling of his colleague with a slight grin on his face.

“You want to see? I have video, I have,” Mokter says with a cheeky grin.

I politely refuse Mokter’s offer, stomach already queasy merely at the thought of what gruesome pictures he had. Instead, I quickly ask him what happened next.

Mokter was immediately sent to a clinic around Farrer Road. The doctor there opened his work gloves and cleaned the wound, but after inspection told him that he needs to go to a hospital. Mokter was then driven to Khoo Teck Puat hospital, where the doctor there informed him he needed to see a specialist for an operation.

“Doctor call the boss, say this man need operation, then I follow one man, go one bed, hospital dress, 6pm one man coming along, bring wheel chair, one day after operation.”

I glance at Mokter’s survey form, on which he had indicated he was worried his boss might have spoken something negative when he interacted with the doctor.

“So your boss agreed for the operation?” I ask.

“Yes, accept and claim insurance already also.”

“Then why worry?” I ask curiously.

“Because ah, the driver talking Chinese to the doctor.” The driver was the one who took him to the clinic and hospital. “Talking Chinese, I also dunno.” So, here is one guy for whom the treatment and the WICA claim process has gone smoothly so far, but he still worries if there’s something in the medical files that may trip his case up.

I thank Mokter and he shakes my hand and smiles and walks away. But barely five minutes later, he comes back brandishing his handphone, showing me a picture of the broken blade.

“See this one is the blade. And got some more . . .”

I tell him: please, no, and Mokter grins at my jitters.

Hospital calls boss, doesn’t speak to patient

Arjun injured his ankle when a high beam fell on his ankle in December 2012. He rolls up his well-worn jeans to show me the ankle that was injured.

“Cracking, got cracking,” he notes. Immediately, he was sent to West Point hospital. There, the doctor assessed his injury. “Broken, then waiting see doctor, doctor say must to do op,” Arjun tells me.

He was warded overnight, with the operation scheduled for the following day.

“I one night sleep. Then morning waiting, no breakfast. 12pm still waiting, no makan [nothing to eat]. Then I waiting 3pm then makan come. I say why you now give me makan? How can?” Arjun recalls, with a tone of frustration. He knew straight away that the arrival of the food indicated that the operation had been called off.

“Then no operation?” I asked him to confirm.

“No operation. They say because boss no pay money.”

I question why the boss refused to pay, and if someone had spoken on his behalf.

“Actually, receptionist calling boss, talking what I dunno,” He answers.

Throughout, Arjun did not know what was said to the doctor, nor was he given any updates of his condition or treatment plans when they discharged him from the hospital.

Without an operation, and with the pain still there, Arunachalam decided to seek out a lawyer, and four days later, with his lawyer’s assistance, went to Tan Tock Seng Hospital. “There doctor say, this one, have to…” Arunachalam pauses as his tries to think of the word.

“Cast?” I suggest. He nods. This confirms that he has a bone fracture.

Despite having the aid of a lawyer, it’s still a struggle to get the employer to pay for treatment, which by law, is his responsibility. To date, Arjun’s boss has paid for only half of his Tan Tock Seng Hospital fees. Arjun has had to pay the rest himself.

What does his case record at West Point say? What did the employer tell the doctor about the cause of the accident that ‘justified’ not paying for treatment while Arjun was warded there?

He’s been stressed out. “Everything thinking, high pressure, very tense… I night time cannot sleep. Leg pain. Pain then also think of all problem.”

And yet, “But I thinking, this one [my own case] okay. You know my friend, one friend dying. I compare, some dying, somebody chopping hand, somebody eye no have. This is life. I think this one God helping.” Then, referring to TWC2’s soup kitchen where he gets two meals a day, “[if] this don’t have, I think I die.”

Before he found us, “You know so many time I so hungry. Drinking water only.”

TWC2 is an organization that is dedicated to assisting low-wage migrant workers when they are in difficulty. We are motivated by a sense of fairness and humanity, though our caseload often exceeds our means.